Permit CITY OF T MECHAN I GAL
A DEVELOPMENT SERVICES PERMIT
/ � 1 ' " " d ' � 4 A ( PERM I T # • MEC98 -0019
-_-. 1 3125 SW Hal! Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 01/22/98
PARCEL: 25115BC -02400
SITE ADDRESS...: 16665 SW QUEEN MARY AVE ��®
SUBDIVISION ZONING:
BLOCK LOT • SOURISDICTION: KIN
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE -SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP....: 0 DOMES. INCIN: 0
:GAS 3 -15 HP ° 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP ° 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP - 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 1
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
I Remarks: Install freestanding gas stove and piping
Owner: FEES
GOFF BILL AND LORRAIN GOFF type amount by date recpt
16665 SW QUEEN MARY AVE PRMT $ 25.00 JSD 01 /21/98 KING CITY
KING CITY OR 97224 . SPCT $ 1.25 JSD 01 /21/98 KING CITY
Phone #:
Contractor: •
T & K MECHANICAL
TIMOTHY S WYNNE
11525 SW CANYON $ 26.25 TOTAL
BEAVERTON OR 97005
Phone #: 626 -4652
Reg #.. : 001211
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started _____
I within 1:• days of issuance, or if work is suspended for lore
I than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are .
set forth in OAR 952 -, -0010 through OAR 952 -001 -0080. You may
obtain copies of these rules or direct questions' to OUNC by calling ,l
_
(503)246-9187. . _ __ T�
/___ 7.
Issue By: _.�'i P ermittee Signature:
IF
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
+++++++++++++++++++++++++++++++++++++++++++++++++ + ++ + + + + + + + + + + + + + + + + + + + + + + + + + ++
- JAN- 21 -'Se WED 13:06 ID: FAX NO: 1406 P02
• CITY OF TIGARD Mechanical Permit Application Recd By (Z- -,
13125 SW HALL BLVD_ Commercial and Residential Date Recd ( - 2-. l - 9. f
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST 1 -- 2- - - q,.,:i
Permit* /Kt; C 9Ss- c5T11 �
Print or Type caitedo /zz' c , 1 - k7-
Incomplete or illegible applications will not be accepted t.lyi voi. - ( - rya =fie(
Name of DevebpmeaIPr6jei Description
Table 1A Mechanical Code 0V PRICE AMT
Job sure Address sows A) Permit Fee - - 10.00
Address /'(o('5 Cl (eeii KQu ,
Bldg* Ciryr$iate U Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents ,
Nome (or named Easiness) ' 2.) Furnace 100,000 BTU* 7.50
Including duds & vents
Owner Goa- -- 6; I( / Y(.1 I vi Meiling Adre'+ 3.) Floor Furnace 6,00
Including vent
City /SUw 2 1p'I Phone 4.) Suspended heater, Wall heater 6.00
/l vi,.., � R or floor mounted neater
j N for name dt er+slnesg) 5,) Vent not Included In appliance permit 3 .00
Occupant mailing Ad 6.) t3eile( or comp, heat pump, air cond. 6,00
to . 3 HP: absorb unit to 100K BUT"'
ChviState Z19 Phone 7,) Boiler or comp, heat burnt, air cond. 11.00
315 HP; absorb unit to SOOK BTU"
Contractor Name 6.) Boiler or comp, heat pump, air cond, 15.00
(Prior to ( K A.P . 41 „t, cc 15-30 HP; absorb unit.5 -1 mil BTU"*
issuance "i „ ""a Aenf°'a 9.) Boiler or comp. heat pump, air pond_ 22.50
applicant I15;. 5i. ea v 01^---4 _ 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all 0 zio - Phone 10.) Boiler or comp, heat pump, air cent 37,50
must contractor � , v 1.1-elvk c'y 42,210- 4/66A.... > 50 HP: absorb unit 1.75 mil BTU -
license Oregon Conte, Cont. Board Lic.O Ex ,E, Date 11.) Air handling unit to 10,000 CFM 4.50 •
Information i �, 1165 . 3 - i ' - `e
fnr COT COT Brqano.e M..- Metro 4 Exp- Oste 12.) Air handling unit 10,000 CFM 7.50
database _ c--''
Architect Name 13.) Non - portable evaporate cooler 4.50
•
Or huNkn9 Ada... 14.) Vent ran connected to a single duct 3.00
Engineer Ca rawo Zip l Piwne 15.) Ventilation systern not included in 4.50 •
appliance permit
Describe work Mew 0 Addtdon 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential O .
Additional Descripiion work 17.) Domestic incinerators 7.50
1 19,) Commercial or industrial type 30.00
• r • --! -i S ` , , 4' 4' K 4 i i� t2r. .. Incinerator .
11 F_,tisting use of 19.) Repair units 4.50
building or property , 5rP -
20.) Wood stave 4,50 •
Propoaed use of 21.) Clothes dryer, etc. 450
budding or property w 5.-7 17 -
22) Other units - 7 /� . 1, /J _ 4,50
r Type of fuel - oil C:i natural gas LPCa6 electric O 23.) Gas piping one to four outlets . 2.00 w
I hereby adcnovriGdge that I ha reed this application, that the 24,) More than 4-per outlets (each) .50
information given is correct that I am the owner or authonzed agent of •
the owner, that plans submitted are in compliant with Oregon State QTY. SUBTOTAL rjU
laws. .
Signature Ovate $)Agent Date -SUBTOTAL
/( z , . ,: 5% SURCHARGE
Contact Persoilllame Phone PLAN REVIEW 25% OF SUBTOTAL
TOTAL
I:mdst\mechprntdioc (rev 9 'Minimum permit fee is 325 * 5% surcharge
"Residential NC requires site plan showing placement of unit
•
5/30/00 Activities for Case #: MEC98 -00019
1:33:22 PM EXPIRED
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By - Disp. Level By Updated Notes
MECA007 Application received 1/21/98 JSD FAX JSD 1/22/98 faxed over by Rosie
MECA008 Create Permit 1/22/98 JSD PASS JSD 1/22/98
MECA799 Final Inspection 3/3/00 KS NOTE RB 3/8/00 Phone contacyt only.
MECA705 Gas Line Insp 1/22/98 2/5/98 KS PASS J *H 2/5/98 30 psi
MECA715 Mechanical Insp 1/22/98 2/5/98 KS FAIL J *H 2/5/98 Provide access for venting
inspection at attic (provide
insulation if not installed and
maintain clearance at b- vent.)
Call for reinspection item #2
• above.
MECA060 (F) Issue permit 1/22/98 JSD PASS JSD 1/22/98
MECA845 Request inspection research 5/19/00 JMT DONE No Hold JMT 5/19/00
MECA880 Expired by limitation 5/22/00 HAP DONE No Hold AKJ 5/22/00
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Page 1 of 1
1 CITY OF TIGARD BUILBING INSP CTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: vZ — 98 A.M. P.M. MST:
Location: /“155- 4 BUP: p
Tenant: Suite:, Bldg: ''0 MEC: r 7/
Contractor: = PLM:
Owner .. e i 'U hone. ELC:
ELR:
� SIT:
BUILDING BLDG (con't) PLUMBING C' CHANICAL2) ELECTRICAL SITE
Site Post/Beam 'Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In / Ceiling Water Line
Slab Framing Top Out a`ar Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct r Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved A y.. v-. W Annrov •. Approved Approved
Appr /Sdwlk .. '• v =. Not Approved lo • ..rove. Not Approved Not Approved
FINAL FINAL d iiiiip FLNAL FINAL
4
/! fir
/ _ Ai 9 ! C J a+.. So S: / O'er / iCL[/ 7
`O"G�• %5 jet 1 >S L?-i S,fri* .i GO
4771 C O t /2 MAST - 2./9-77 O'L? 1.' -410 7 1 / i
i J /A/774-i A-1 ti! 0 z_„. ,,-C • ` •-2 Y —
_ . ' d ' e.-- 1 /e- '' /L!E,4=' 0 &_; P-7 - . i ° — Z____-
-
o
0 Call for reinspection 0 Reinspection fee of $ required before next inspection 0 Unable to inspect
Inspector: 4 Date: YP Page • of
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24 - Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
Date Requested AM PM BLD
Location /�, r0 (' 5 ?IJJ 0 /? in Suite CP 9
Contact Person Ph PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing NOT REQUESTED
Foundation FOUND DURING RESEARCH' FPS
Cr l Dr N O INSPECTION(s) IN FILE S SGN
Crawl Drain �
Slab SIT
Post & Beam -7/ ,21 /Ci 5
Ext Sheath /Shear
Int Sheath /Shear
Framing #; e/34._ ! /1!S rht- 9c. — ref (C, wec I,.1 ,.s,,. , CA• `•
Insulation Zlo �S 'T4 I4 GtGKb� - 14 CA- 4— I �
Drywall Nailing
Firewall
Fire Sprinkler G' °A ro Df 1AT <Ay
Fire Alarm "
Susp'd Ceiling s K� �,v 7 '/6 (�J S
Miscf A�o�� 1� N.c e / �
Final -
PASS PART FAIL �' 4 - 45
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART F
Post & Beam
Rough In
Gas Line < ,, ;- '
Smoke Dampers
alW11 •
• S PART AIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk _ 3 �Q
Other Date Ins Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.